Study Links Stimulant Prescription Rates to Teen Drug Misuse

On April 18, 2023, JAMA Network Open published an article linking stimulant prescription rates for ADGD to teen drug misuse. The study analyzed the medical and nonmedical use of prescription stimulants (NUPS) among students in secondary schools across the United States.

Using data from a survey administered as part of the Monitoring the Future Study, researchers conducted a cross-sectional analysis of data from 2005 to 2020. The researchers focused on nearly 3,300 secondary schools in the US, looking at data from 231,141 eighth­­-, tenth-, and twelfth-grade students.

Careful data analysis determined that the NUPS rates varied in each school, county, state, and region. Some schools had NUPS rates of 0%, while others had rates over 25%, indicating that drug misuse rates depend on each school's culture and stimulant prevalence.

Additionally, the researchers noted a trend in stimulant therapy prescription and NUPS, explaining that as stimulant therapy prescription rates increase, NUPS rates increase even while controlling other factors. According to the study, students in schools with the highest rate of stimulant prescriptions were 36% more likely to use stimulants for nonmedical reasons.

Researchers also identified additional factors that contribute to increased rates of stimulant misuse. One factor is parental education, as researchers determined that schools with parents with higher education levels also had higher NUPS.

Furthermore, being in the Northeast and suburban areas increased the risk of stimulant misuse. Areas with higher percentages of non-Hispanic White students also exhibited increased misuse rates. Finally, schools where 10–19% of students binge drink had higher NUPS rates.

The NIH notes that many individuals who misuse stimulants receive them free from friends or family with a valid ADHD diagnosis and stimulant prescription. This level of prescription sharing is a type of prescription drug fraud that harms individuals and the healthcare system.

Side effects of stimulants such as Adderall and the withdrawal effects associated with discontinuing use can cause complications and threaten patient health. Beyond the individual, using stimulants by individuals who do not necessitate it keeps the supply away from those who need it.

Considering the ongoing Adderall shortages, minimizing NUPS and conserving the supply for patients who need it is critical.

“The key takeaway here is not that we need to lessen prescribing of stimulants for students who need them, but that we need better ways to store, monitor, and screen for stimulant access and use among youth to prevent misuse,” said the study author Sean Esteban McCabe, PhD, in the NIH press release.

“There’s variation in stimulant misuse across different schools, so it’s important to assess schools and implement personalized interventions that work best for each school. It’s also critical to treat and educate teens on prescription stimulants as the medications they are intended to be and limit their availability as drugs of misuse,” he continued.